A 25-year-old graduate student with a history of recurrent ear infections as a child feels anxious and sweats when she is in the examination room with her primary care physician. She recently got a roommate, a nursing student, who leaves her stethoscope on the coffee table after returning from class. The patient sweats and feels her heart start to race whenever she sees the stethoscope. This patient's response to her roommate's stethoscope is an example of which of the following phenomena?

Question

A 25-year-old graduate student with a history of recurrent ear infections as a child feels anxious and sweats when she is in the examination room with her primary care physician.  She recently got a roommate, a nursing student, who leaves her stethoscope on the coffee table after returning from class.  The patient sweats and feels her heart start to race whenever she sees the stethoscope.  This patient's response to her roommate's stethoscope is an example of which of the following phenomena?

Quizplus · Accepted Answer

11ec160b_3607_6b79_9249_e3d39795d213_MD0001_00 This patient's response to her roommate's stethoscope is an example of classical conditioning. Childhood encounters with her primary care physician for ear infections (unconditioned stimulus) caused anxiety (an automatic reaction called an unconditioned response), resulting in sweating at subsequent health care visits. The encounters with her physician are most likely associated with the presence of a stethoscope (the conditioned stimulus). Repeated pairing of the unconditioned stimulus (eg, physician encounter) with the conditioned stimulus (eg, stethoscope) allows the conditioned stimulus alone to elicit a learned, conditioned response (eg, sweating). Classical conditioning provides one explanation for "white coat hypertension," a condition in which a physician's white coat or examination room acts as a conditioned stimulus, causing anxiety and transient blood pressure elevation during health care visits. (Choices B, C, and D) In operant conditioning, rewards and punishments are used to reinforce behavior. Negative punishment is the removal of a reward to decrease a behavior (eg, a teenager's driving privileges are taken away after returning home past curfew). With negative reinforcement, desired behavior is strengthened through the removal of a negative outcome (eg, suffering a bad sunburn promotes application of sunscreen to prevent future sunburns). (Choice E) Reaction formation is the unconscious transformation of an unacceptable impulse or emotion into its opposite (eg, if this patient tells her physician she enjoys clinic visits and acts extremely relaxed during the examination to defend against underlying anxiety). (Choice F) Regression is a defense mechanism that involves unconsciously reverting to a less mature way of coping with difficulties (eg, if this patient starts sleeping with a stuffed animal to manage anxiety about an upcoming appointment). Educational objective: Classical conditioning involves a neutral stimulus being repeatedly paired with a non-neutral stimulus that elicits a reflexive, unconditioned response. Over time, the formerly neutral stimulus is able to evoke a conditioned response by itself in absence of the non-neutral stimulus. __________ References: White coat hypertension: improving the patient-health care practitioner relationship. (http://www.ncbi.nlm.nih.gov/pubmed/25999772)

A 25-Year-Old Graduate Student with a History of Recurrent Ear